Challenges in management of transient hyperinsulinism – a retrospective analysis of 36 severely affected children

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Henrike Hoermann ◽  
Marcia Roeper ◽  
Roschan Salimi Dafsari ◽  
Felix Koestner ◽  
Christina Reinauer ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Retrospective Analysis ◽  
Blood Glucose Measurement ◽  
Glucose Measurement ◽  
Intravenous Glucose ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Lower Blood ◽  
Subsequent Episode ◽  
The University

Abstract Objectives Transient hyperinsulinism (THI) is a hypoglycemia disorder which resolves spontaneously within the first weeks or months of life. The pathomechanism of THI is not elucidated yet; however, it is known that perinatal stress predisposes for THI. We aimed to characterize the clinical phenotype and treatment of children with THI, and to identify options for improved management. Methods A retrospective analysis of 36 children with THI treated at the University Children’s Hospital Düsseldorf between 2007 and 2019 was performed. Results All children had risk factors for neonatal hypoglycemia or indicators of perinatal stress. Eighty three percent were diagnosed with hypoglycemia on day of life (DOL)1. None of the six diagnosed later had routine blood glucose screening and showed significantly lower blood glucose levels at the time of first blood glucose measurement compared to the children diagnosed on DOL1. Ninety seven percent of all children received intravenous glucose, 42% received continuous glucagon and 81% were started on diazoxide. Diazoxide withdrawal and subsequent fasting tests lacked standardization and were based on clinical experience. Three patients had a subsequent episode of hypoglycemia, after fasting studies only demonstrated “clinical” remission without proving the ability to ketogenesis. Conclusions Any kind of perinatal stress might pose a risk to develop THI, and postnatal monitoring for hypoglycemia still needs to be improved. Diazoxide is effective in children with THI; however, further studies are needed to guide the development of criteria and procedures for the initiation and discontinuation of treatment. Furthermore, establishing consensus diagnostic criteria/definitions for THI would improve comparability between studies.

scholarly journals Antidiabetic Activity of Sungkai (Peronema canescens Jack) Leaves Ethanol Extract on the Male Mice Induced Alloxan Monohydrate

2021 ◽  
Vol 6 (2) ◽  
pp. 64
Author(s):  
Madyawati Latief ◽  
Putri M. Sari ◽  
Liddini T. Fatwa ◽  
Indra L. Tarigan ◽  
H. P. Vasantha Rupasinghe
Keyword(s):  
Body Weight ◽  
Blood Glucose ◽  
Urine Volume ◽  
Ethanol Extract ◽  
Blood Glucose Measurement ◽  
Antidiabetic Activity ◽  
Glucose Measurement ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Reduce Blood Glucose

  Sungkai (Peronema canescens Jack) is an alternative natural ingredient that can be used as an antidiabetic containing several secondary metabolites which are thought to reduce blood glucose levels by inhibiting the action of the α-glucokinase enzyme and increasing the activity of antioxidant enzymes and being able to regenerate β-cells, damaged pancreas so that insulin deficiency can be overcome. The aim of this study was to determine the effect of P. canescens leaves ethanol extract on antidiabetic activity and to determine the effect of various doses of sungkai leaf ethanol extract as antidiabetic. The scientific research method used in this study was a completely randomized design (CRD) and data analysis used in this study is the one way ANOVA, following by the Duncan test. Blood glucose measurement in treated mice was carried out 3 times. Mice were devided into five groups, three mice in each group, and each group was administered different dosages of sungkai extract (T1 = extract 175 mg/kg body weight; T2 = extract 350 mg/kg body weight; T3 = extract 700 mg/ kg body weight). First, the mice were acclimatized for six days and the injection of treatment was started at day 7. Blood glucose levels, urine volume, body weight and daily drinking of mice was carried out before induction (day 0), after induction (day 8) and after the end of treatment for 10 days (day 18), was carried out using the Point of Care Test (POCT) method using the Easy Touch GCU. The results showed that the ethanol extract of sungkai leaves had the potential to reduce blood glucose levels in mice. The ethanol extract of sungkai leaves at a dose of 350 mg/kg body weight has the most optimal potential to reduce blood glucose levels, urine volume, daily drinking, and body weight. 

scholarly journals Upper vs. lower extremity: Does the site of steroid injection have a different effect on blood glucose levels in patients with diabetes?

2020 ◽  
Vol 6 (2) ◽  
Author(s):  
Emilyn Anderi
Keyword(s):  
Blood Glucose ◽  
Steroid Injection ◽  
Clinical Decision ◽  
Blood Glucose Measurement ◽  
Glucose Measurement ◽  
Diabetic Patients ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Patients With Diabetes ◽  
Dose Injection

A clinical decision report appraising Twu J, Patel N, Wolf JM, Conti Mica M. Impact of variation of corticosteroid dose, injection site, and multiple injections on blood glucose measurement in diabetic patients. J Hand Surg Am. 2018;43(8):738-744. https://doi.org/10.1016/j.jhsa.2018.06.005 for a patient with diabetes and osteoarthritis.

The Prognostic Value of Admission Blood Glucose Levels in Nigerian Patients with Stroke: A 10-year Retrospective Analysis

2004 ◽  
Vol 34 (3) ◽  
pp. 184-185 ◽  
Author(s):  
A O Ogunrin ◽  
E Unuigbe ◽  
A Eregie ◽  
E Amu ◽  
A Isah ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Retrospective Analysis ◽  
Prognostic Value ◽  
Glucose Levels ◽  
Blood Glucose Levels

scholarly journals POLYCYSTIC OVARIAN SYNDROME;

2012 ◽  
Vol 19 (06) ◽  
pp. 786-788
Author(s):  
KIRAN BUTT ◽  
FARAH DEEBA ◽  
HAVAIDA ATTIQUE
Keyword(s):  
Blood Glucose ◽  
Lipid Profile ◽  
Glucose Level ◽  
Fasting Blood Glucose ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Increased Risk ◽  
Commercial Kits ◽  
The University ◽  
Ovarian Syndrome

Objective: The objective of the present study was to determine the changes in the glucose level and lipid profile in patients withpolycystic ovarian syndrome (PCOS). Study Design: Descriptive study. Place and Duration of the study: This study was conducted atInstitute of Molecular Biology and Biotechnology, The University of Lahore from June 2009 to June 2010. Patients and Methods: Total 50patients with PCOS were included and 50 age-matched control subjects were also selected for comparison. Their glucose levels and lipidprofile were assessed using commercial kits. The data thus obtained was subjected to statistical analysis. Results: Significant differences(P<0.05) in fasting blood glucose level and individual parameters of lipid profile were observed in women with PCOS. A higher prevalence ofhypertriglyceridemia, hypercholesterolemia, higher LDL, lower HDL and higher fasting blood glucose levels was explored in PCOS womenthan controls. Conclusions: Abnormal glucose level and lipid profile in PCOS women showed that these women are at an increased risk ofdeveloping diabetes and subsequently cardiovascular diseases.

scholarly journals Maintaining Blood Glucose Levels in Range (70–150 mg/dL) is Difficult in COVID-19 Compared to Non-COVID-19 ICU Patients—A Retrospective Analysis

2020 ◽  
Vol 9 (11) ◽  
pp. 3635
Author(s):  
Rajat Kapoor ◽  
Lava R. Timsina ◽  
Nupur Gupta ◽  
Harleen Kaur ◽  
Arianna J. Vidger ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Retrospective Analysis ◽  
Insulin Dose ◽  
Glucose Levels ◽  
Cell Dysfunction ◽  
Daily Insulin ◽  
Daily Insulin Dose ◽  
Blood Glucose Levels ◽  
Time In Range ◽  
Insulin Use

Beta cell dysfunction is suggested in patients with COVID-19 infections. Poor glycemic control in ICU is associated with poor patient outcomes. This is a single center, retrospective analysis of 562 patients in an intensive care unit from 1 March to 30 April 2020. We review the time in range (70–150 mg/dL) spent by critically ill COVID-19 patients and non-COVID-19 patients, along with the daily insulin use. Ninety-three in the COVID-19 cohort and 469 in the non-COVID-19 cohort were compared for percentage of blood glucose TIR (70–150 mg/dL) and average daily insulin use. The COVID-19 cohort spent significantly less TIR (70–150 mg/dL) compared to the non-COVID-19 cohort (44.4% vs. 68.5%). Daily average insulin use in the COVID-19 cohort was higher (8.37 units versus 6.17 units). ICU COVID-19 patients spent less time in range (70–150 mg/dL) and required higher daily insulin dose. A higher requirement for ventilator and days on ventilator was associated with a lower TIR. Mortality was lower for COVID-19 patients who achieved a higher TIR.

scholarly journals Discrepancies Between Blood Glucose and Interstitial Glucose—Technological Artifacts or Physiology: Implications for Selection of the Appropriate Therapeutic Target

2017 ◽  
Vol 11 (4) ◽  
pp. 766-772 ◽  
Author(s):  
Thorsten Siegmund ◽  
Lutz Heinemann ◽  
Ralf Kolassa ◽  
Andreas Thomas
Keyword(s):  
Blood Glucose ◽  
Therapeutic Target ◽  
Diabetes Management ◽  
Glucose Monitoring ◽  
Blood Glucose Measurement ◽  
Glucose Measurement ◽  
Glucose Levels ◽  
Therapeutic Decisions ◽  
The Impact ◽  
Selection Of

Background: For decades, the major source of information used to make therapeutic decisions by patients with diabetes has been glucose measurements using capillary blood samples. Knowledge gained from clinical studies, for example, on the impact of metabolic control on diabetes-related complications, is based on such measurements. Different to traditional blood glucose measurement systems, systems for continuous glucose monitoring (CGM) measure glucose in interstitial fluid (ISF). The assumption is that glucose levels in blood and ISF are practically the same and that the information provided can be used interchangeably. Thus, therapeutic decisions, that is, the selection of insulin doses, are based on CGM system results interpreted as though they were blood glucose values. Methods: We performed a more detailed analysis and interpretation of glucose profiles obtained with CGM in situations with high glucose dynamics to evaluate this potentially misleading assumption. Results: Considering physical activity, hypoglycemic episodes, and meal-related differences between glucose levels in blood and ISF uncover clinically relevant differences that can make it risky from a therapeutic point of view to use blood glucose for therapeutic decisions. Conclusions: Further systematic and structured evaluation as to whether the use of ISF glucose is more safe and efficient when it comes to acute therapeutic decisions is necessary. These data might also have a higher prognostic relevance when it comes to long-term metabolic consequences of diabetes. In the long run, it may be reasonable to abandon blood glucose measurements as the basis for diabetes management and switch to using ISF glucose as the appropriate therapeutic target.

scholarly journals Skrining Fitokimia dan Potensi Antidiabetes Ekstrak Etanol Herba Ciplukan (Physalis Angulata L) pada Tikus Putih (Rattus Novergicus) yang Diinduksi Aloksan

2019 ◽  
Vol 4 (3) ◽  
pp. 98-107
Author(s):  
Hendra Pratama Maliangkay ◽  
Rolef Rumondor ◽  
Mynia Kantohe
Keyword(s):  
Blood Glucose ◽  
Rattus Norvegicus ◽  
Ethanol Extract ◽  
Negative Control ◽  
Glucose Measurement ◽  
Percentage Decrease ◽  
Glucose Levels ◽  
White Rats ◽  
Blood Glucose Levels ◽  
Physalis Angulata

The purpose of this study to determine the anti-diabetic potential of ciplukan herbal ethanol extract (Physalis angulata L) in white rats (Rattus norvegicus) induced alloxan given intraperitoneally and comparing its effectiveness with glibenclamide. This study uses 5 groups namely giving aquadest as normal control, giving alloxan as a negative control, giving alloxan and glibenclamide as a positive control and the ethanol extract of ciplukan herbal with a dose of 150 mg/kg BB and 300 mg/kg BB. Blood glucose measurement performed on day 0 (three days after induction), day 7, and day 14. The results showed that ethanol extract of ciplukan herbal (Physalis angulata L) can lower blood glucose levekls. A dose of 150 mg/kg BB have percentage decrease in blood glucose levels on day 7 and day 14 respectively by 14.1%and 70.5%. dose of 300 mg/kg BB have a percentage decrease in blood glucose levels on day 7 and day 14 respectively by 70.5%.and 69.5%. a dose of 150 mg/kg BB is more effective as an anti-diabetic compared with a dose of 300 mg/kg BB. Ethanol extract of ciplukan herbal (Physalis angulata L) also has an activity to repair damaged pancreatic-β cells in rats (Rattus norvegicus) induced by alloxan.

scholarly journals Exogenous Ketones Lower Blood Glucose Level in Rested and Exercised Rodent Models

Nutrients ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 2330 ◽  
Author(s):  
Ari ◽  
Murdun ◽  
Koutnik ◽  
Goldhagen ◽  
Rogers ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Rodent Models ◽  
Lower Blood Glucose ◽  
Post Exercise ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Lower Blood Glucose Level ◽  
Lower Blood

Diseases involving inflammation and oxidative stress can be exacerbated by high blood glucose levels. Due to tight metabolic regulation, safely reducing blood glucose can prove difficult. The ketogenic diet (KD) reduces absolute glucose and insulin, while increasing fatty acid oxidation, ketogenesis, and circulating levels of β-hydroxybutyrate (βHB), acetoacetate (AcAc), and acetone. Compliance to KD can be difficult, so alternative therapies that help reduce glucose levels are needed. Exogenous ketones provide an alternative method to elevate blood ketone levels without strict dietary requirements. In this study, we tested the changes in blood glucose and ketone (βHB) levels in response to acute, sub-chronic, and chronic administration of various ketogenic compounds in either a post-exercise or rested state. WAG/Rij (WR) rats, a rodent model of human absence epilepsy, GLUT1 deficiency syndrome mice (GLUT1D), and wild type Sprague Dawley rats (SPD) were assessed. Non-pathological animals were also assessed across different age ranges. Experimental groups included KD, standard diet (SD) supplemented with water (Control, C) or with exogenous ketones: 1, 3-butanediol (BD), βHB mineral salt (KS), KS with medium chain triglyceride/MCT (KSMCT), BD acetoacetate diester (KE), KE with MCT (KEMCT), and KE with KS (KEKS). In rested WR rats, the KE, KS, KSMCT groups had lower blood glucose level after 1 h of treatment, and in KE and KSMCT groups after 24 h. After exercise, the KE, KSMCT, KEKS, and KEMCT groups had lowered glucose levels after 1 h, and in the KEKS and KEMCT groups after 7 days, compared to control. In GLUT1D mice without exercise, only KE resulted in significantly lower glucose levels at week 2 and week 6 during a 10 weeks long chronic feeding study. In 4-month and 1-year-old SPD rats in the post-exercise trials, blood glucose was significantly lower in KD and KE, and in KEMCT groups, respectively. After seven days, the KSMCT group had the most significantly reduced blood glucose levels, compared to control. These results indicate that exogenous ketones were efficacious in reducing blood glucose levels within and outside the context of exercise in various rodent models of different ages, with and without pathology.

Antidiabetic Activity of Peperomia pellucida In Streptozotocin-Induced Diabetic Mice

2021 ◽  
Vol 7 (2) ◽  
pp. 120-129
Author(s):  
Sholihatil Hidayati
Keyword(s):  
Blood Glucose ◽  
Ethanol Extract ◽  
Hexane Fraction ◽  
Antidiabetic Activity ◽  
Diabetic Mice ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Potential Development ◽  
Lower Blood ◽  
Development Objectives

Background: Diabetes mellitus is a heterogeneous group of diseases in the form of disorders in the body's metabolism clinically. Peperomia pellucida herbs have phytochemical containing which is antidiabetic potential development. Objectives: This study was conducted to compare the antidiabetic activity of ethanol extract and n-hexane fraction of Peperomia pellucida. Material and Methods: This research was conducted by make diabetic mice with 50 mg/kg.bw of streptozotocin induction, which was then treated with ethanol extract and n-hexane fraction of Peperomia pellucida with doses 250 mg/kgbw for 7 days.  Results: The results showed that the ethanol extract and n-hexane fraction of Peperomia pellucida reduced blood glucose levels in diabetic mice due to streptozotocin induction. The n-hexane fraction of Peperomia pellucida can lower blood glucose levels as much 244.00 ± 18.99 mg/dL better than the ethanol extract, which is 99.50 ± 28.17 mg/dL. Conclusions: Peperomia pellucida herb has the potential to be developed as an antidiabetic agent.

scholarly journals Protective effect of cyanidin-3-O-glucoside on neonatal porcine islets

2017 ◽  
Vol 235 (3) ◽  
pp. 237-249 ◽  
Author(s):  
Chao Li ◽  
Bin Yang ◽  
Zhihao Xu ◽  
Eric Boivin ◽  
Mazzen Black ◽  
...  
Keyword(s):  
Drinking Water ◽  
Blood Glucose ◽  
Related Factor ◽  
Post Transplantation ◽  
Lower Blood Glucose ◽  
Glucose Levels ◽  
Porcine Islets ◽  
Blood Glucose Levels ◽  
Lower Blood ◽  
Neonatal Porcine Islets

Oxidative stress is a major cause of islet injury and dysfunction during isolation and transplantation procedures. Cyanidin-3-O-glucoside (C3G), which is present in various fruits and vegetables especially in Chinese bayberry, shows a potent antioxidant property. In this study, we determined whether C3G could protect neonatal porcine islets (NPI) from reactive oxygen species (H2O2)-induced injury in vitro and promote the function of NPI in diabetic mice. We found that C3G had no deleterious effect on NPI and that C3G protected NPI from damage induced by H2O2. Significantly higher hemeoxygenase-1 (HO1) gene expression was detected in C3G-treated NPI compared to untreated islets before and after transplantation (P < 0.05). Western blot analysis showed a significant increase in the levels of phosphorylated extracellular signal-regulated kinase 1/2 (ERK1/2) and phosphatidylinositol 3-kinase (PI3K/Akt) proteins in C3G-treated NPI compared to untreated islets. C3G induced the nuclear translocation of nuclear erythroid 2-related factor 2 (NRF2) and the significant elevation of HO1 protein. Recipients of C3G-treated NPI with or without C3G-supplemented drinking water achieved normoglycemia earlier compared to recipients of untreated islets. Mice that received C3G-treated islets with or without C3G-supplemented water displayed significantly lower blood glucose levels at 5–10 weeks post-transplantation compared to mice that received untreated islets. Mice that received C3G-treated NPI and C3G-supplemented drinking water had significantly (P < 0.05) lower blood glucose levels at 7 and 8 weeks post-transplantation compared to mice that received C3G-treated islets. These findings suggest that C3G has a beneficial effect on NPI through the activation of ERK1/2- and PI3K/AKT-induced NRF2-mediated HO1 signaling pathway.

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